IOM’s Future of Nursing report reinforces findings of anesthesia studies in Health Affairs and Nursing Economic$

PARK RIDGE, Illinois—Landmark findings from the Institute of Medicine (IOM) assert that expanding the role of nurses in the U.S. healthcare system will help meet the growing demand for medical services. The IOM report urges policymakers to remove policy barriers that hinder nurses—particularly advanced practice registered nurses such as Certified Registered Nurse Anesthetists (CRNAs)—from practicing to the full extent of their education and training.
The report, titled “The Future of Nursing: Leading Change, Advancing Health,” was released in the wake of two definitive studies recently published in leading peer-reviewed health journals that confirmed the safety and cost-effectiveness of nurse anesthetists.
“The new report from the Institute of Medicine is further evidence that all nurses, including advanced practice registered nurses, play an integral role in the U.S. health system,” said Paul Santoro, CRNA, president of the American Association of Nurse Anesthetists (AANA). “Millions of previously uninsured Americans are about to enter the system, and millions more baby boomers are coming eligible for the Medicare program.  In conjunction with the recent RTI study that called for the repeal of the supervision rule, the IOM report shows it is long overdue that these highly qualified professionals be allowed to practice to the full extent of their capabilities, ensuring all Americans access to safe, affordable healthcare.”
The RTI study, titled “No Harm Found When Nurse Anesthetists Work Without Supervision by Physicians,” was published in the August 2010 issue of Health Affairs, the nation’s preeminent health policy journal. This study, which examined nearly 500,000 individual cases in 14 states that removed the federal physician supervision requirement for nurse anesthetists between 2001 and 2005, revealed that patient outcomes did not differ between the states that do not require physician supervision and states that do. Further, the study confirmed that there are no differences in patient outcomes when anesthesia services are provided by CRNAs, physician anesthesiologists, or CRNAs supervised by physicians.
 
In addition, the Lewin Group published a study titled “Cost Effectiveness Analysis of Anesthesia Providers” in the May/June issue of The Journal of Nursing Economic$. This study considered the different anesthesia delivery models in use in the United States today, including CRNAs acting solo, physician anesthesiologists acting solo, and various models in which a single anesthesiologist directs or supervises one to six CRNAs.  The results show that CRNAs acting as the sole anesthesia provider cost 25 percent less than the second lowest cost model. Alternatively, the model in which one anesthesiologist supervises one CRNA is the least cost-efficient model.  
CRNAs are anesthesia professionals with 7-8 years of education and training related to their specialty,  including a four-year bachelor’s in nursing, at least one year of experience as a registered nurse in an acute care setting, and a master’s degree from a 24-36 month nurse anesthesia educational program.  In addition, CRNAs must fulfill continuing education requirements every two years in order to remain certified to practice. By the year 2025, a doctorate of nursing anesthesia practice will be required for entry into the profession.
The IOM report was the work of the IOM’s committee on the Robert Wood Johnson Foundation (RWJF) Initiative on the Future of Nursing, which consists of doctors, nurses, academicians, and other healthcare representatives.
 
About the American Association of Nurse Anesthetists
Founded in 1931 and located in Park Ridge, Ill., the AANA is the professional organization for more than 42,000 Certified Registered Nurse Anesthetists and student nurse anesthetists. As advanced practice registered nurses, CRNAs are the hands-on providers of more than 32 million anesthetics to patients in the United States each year. CRNAs practice in every setting where anesthesia is available and in some states are the sole anesthesia professionals in nearly 100 percent of rural hospitals.